Post-antibiotic era could be at hand

December 11, 2013

Revelations that more than 20 new born babies at one of the nation’s largest health services were carrying a potentially fatal superbug have underlined AMA calls for the responsible prescription and use of antibiotics.The Age newspaper has revealed that Vancomycin-resistant enterococcus (VRE) has colonised the gut of 21 babies in intensive and special care units at the Monash Medical Centre and Casey Hospital.Though none of the babies has yet fallen ill, there are concerns any infection could be difficult to treat, and strict infection controls are being observed among staff caring for the babies.The incident, and a Macquarie University study that found some bacteria have developed resistance to antiseptics and disinfectants commonly used in hospitals, has underlined concerns about the spread of antibiotic-resistant bacteria and the need for vigilance in the use of such medications.The AMA last month joined with NPS MedicineWise and several other health organisations to warn that over-use of antibiotics posed a threat to all.AMA President Dr Steve Hambleton said the unnecessary or incorrect use of antibiotics encouraged the development of dangerous antibiotic-resistant bugs.Dr Hambleton said antibiotics should only be prescribed when clinically appropriate, such as when there is likely to be a substantial benefit to the patient, and should only be used in accordance with clinical guidelines.He added that it was important that patients understood that antibiotics are only effective against bacterial infections and were not a treatment for colds or influenza, and said patients must take the whole course of any antibiotic prescribed.In addition to its public advocacy on responsible antibiotic use, the AMA has also been working with the Australian Veterinary Association to address concerns about the use of antibiotics in animals, particularly those farmed for food.Antibiotics are widely used in farming in other countries, including in the United States, contributing to fears of a rapid build-up of antibiotic resistance among bacteria commonly found in both humans and animals.Britain’s Chief Medical Officer Professor Dame Sally Davies earlier this year warned that the rise of antibiotic resistance posed a “catastrophic threat” that could make even minor and routine medical procedures deadly, and Australasian Society for Infectious Diseases President Associate Professor David Looke said widespread and unfettered use of antibiotics was driving an “alarming” upsurge in antibiotic resistance.Fears that the post-antibiotic era has already arrived have been fuelled by the experience of doctors in New Zealand, where a patient who died in July was found to be infected with a bacterium resistant to all known antibiotics.New Zealand man Brian Poole had been working in India and Vietnam when he fell ill, and was flown back to Wellington for treatment. He was found to be carrying a strain of the Klebsiella Pneumoniae bacterium that was resistant to every antibiotic testing on it in the laboratory.Treating physicians said they had “never seen anything like it”, and warned it was likely to become an increasingly common experience for doctors as antibiotic resistance spread.For more information on the appropriate use of antibiotics, visit www.nps.org.au/antibioticsAdrian Rollins